Hip & pelvis

  • 제34권4호
  • /
  • Pages.245-254
  • /
  • 2022
  • /
  • 2287-3260(pISSN)
  • /
  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
권호 표지
DOI QR코드

DOI QR Code

Adult Proximal Humeral Locking Plate Is a Good Alternative Option in the Treatment of Adolescent Subtrochanteric Femur Fractures: A Case Series and Literature Review

  • Ceyhun Caglar (Department of Orthopedics and Traumatology, Ankara City Hospital) ;
  • Serhat Akcaalan (Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University) ;
  • Merve Bozer (Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University) ;
  • Mustafa Akkaya (Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University)
  • 투고 : 2022.08.02
  • 심사 : 2022.09.22
  • 발행 : 2022.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Management of pediatric subtrochanteric femur fractures (SFFs) is difficult. The aim of this study was to evaluate the outcomes of adolescent SFFs treated with adult proximal humeral locking plates (PHLPs). Materials and Methods: A retrospective analysis of 18 adolescents (11 male, 7 female) with a diagnosis of SFF who underwent internal fixation with a PHLP was conducted. Data regarding injury mechanism, fracture pattern, and time to union were recorded for all patients. In addition, a clinical and functional evaluation of patients was performed using the Harris hip score (HHS), Iowa hip score (IHS), modified Merle d'Aubigne-Postel score (MMAPS), Flynn criteria, and hip range of motion (ROM). Results: The mean age of the patients was 12.72±2.05 years (range, 10-16 years). Radiological observation was performed for evaluation of five different injury mechanisms and different fracture patterns in patients. The mean postoperative HHS was 92.27±5.61, the mean IHS was 90.88±6.46, and the mean MMAPS was 17.22±0.94. According to the Flynn criteria, excellent results were achieved in 14 cases and satisfactory results were obtained in four cases. Measurements of the patients' mean hip ROM values were as follows: 17.77±3.52° in extension, 115.27±6.74° in flexion, 43.05±3.48° in abduction, 27.50±4.28° in adduction, 42.22±4.60° in internal rotation, and 42.22±3.91° in external rotation. Conclusion: Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.

키워드

참고문헌

  1. Segal LS. Custom 95 degree condylar blade plate for pediatric subtrochanteric femur fractures. Orthopedics. 2000;23:103-7. https://doi.org/10.3928/0147-7447-20000201-10
  2. Li Y, Heyworth BE, Glotzbecker M, et al. Comparison of titanium elastic nail and plate fixation of pediatric subtrochanteric femur fractures. J Pediatr Orthop. 2013;33:232-8. https://doi.org/10.1097/BPO.0b013e318288b496
  3. Li Y, Hedequist DJ. Submuscular plating of pediatric femur fracture. J Am Acad Orthop Surg. 2012;20:596-603. https://doi.org/10.5435/JAAOS-20-09-596
  4. Ho CA, Skaggs DL, Tang CW, Kay RM. Use of flexible intramedullary nails in pediatric femur fractures. J Pediatr Orthop. 2006;26:497-504. https://doi.org/10.1097/01.bpo.0000226280.93577.c1
  5. Lascombes P, Haumont T, Journeau P. Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop. 2006;26:827-34. https://doi.org/10.1097/01.bpo.0000235397.64783.d6
  6. Sanzarello I, Calamoneri E, D'Andrea L, Rosa MA. Algorithm for the management of femoral shaft fractures in children. Musculoskelet Surg. 2014;98:53-60. https://doi.org/10.1007/s12306-013-0299-3
  7. Abbott MD, Loder RT, Anglen JO. Comparison of submuscular and open plating of pediatric femur fractures: a retrospective review. J Pediatr Orthop. 2013;33:519-23. https://doi.org/10.1097/BPO.0b013e318287056d
  8. Pate O, Hedequist D, Leong N, Hresko T. Implant removal after submuscular plating for pediatric femur fractures. J Pediatr Orthop. 2009;29:709-12. https://doi.org/10.1097/BPO.0b013e3181b769ea
  9. Samora WP, Guerriero M, Willis L, Klingele KE. Submuscular bridge plating for length-unstable, pediatric femur fractures. J Pediatr Orthop. 2013;33:797-802. https://doi.org/10.1097/BPO.0000000000000092
  10. Malkawi H, Shannak A, Amr S. Surgical treatment of pathological subtrochanteric fractures due to benign lesions in children and adolescents. J Pediatr Orthop 1984;4:63-9. https://doi.org/10.1097/01241398-198401000-00014
  11. Schwarz N, Leixnering M, Frisee H. [Treatment results and indications for surgery in subtrochanteric femur fractures during growth]. Aktuelle Traumatol. 1990;20:176-80. German.
  12. Cortes LE, Triana M, Vallejo F, Slongo TF, Streubel PN. Adult proximal humerus locking plate for the treatment of a pediatric subtrochanteric femoral nonunion: a case report. J Orthop Trauma. 2011;25:e63-7. https://doi.org/10.1097/BOT.0b013e3181f8d9c3
  13. Sink EL, Gralla J, Repine M. Complications of pediatric femur fractures treated with titanium elastic nails: a comparison of fracture types. J Pediatr Orthop. 2005;25:577-80. https://doi.org/10.1097/01.bpo.0000164872.44195.4f
  14. Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J. Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop. 2001;21:4-8.
  15. Gogna P, Mohindra M, Verma S, Thora A, Tiwari A, Singla R. Adult proximal humerus locking plate for fixation of paediatric subtrochanteric fractures. Musculoskelet Surg. 2014;98:189-94. https://doi.org/10.1007/s12306-013-0310-z
  16. Koukakis A, Apostolou CD, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop Relat Res. 2006;442:115-20. https://doi.org/10.1097/01.blo.0000194678.87258.6e
  17. Pombo MW, Shilt JS. The definition and treatment of pediatric subtrochanteric femur fractures with titanium elastic nails. J Pediatr Orthop. 2006;26:364-70. https://doi.org/10.1097/01.bpo.0000203005.50906.41
  18. Corrales LA, Morshed S, Bhandari M, Miclau T 3rd. Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am. 2008;90:1862-8. https://doi.org/10.2106/JBJS.G.01580
  19. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737-55.
  20. Larson CB. Rating scale for hip disabilities. Clin Orthop Relat Res. 1963;31:85-93.
  21. d'Aubigne RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36-A:451-75.
  22. Ovre S, Sandvik L, Madsen JE, Roise O. Comparison of distribution, agreement and correlation between the original and modified Merle d'Aubigne-Postel Score and the Harris Hip Score after acetabular fracture treatment: moderate agreement, high ceiling effect and excellent correlation in 450 patients. Acta Orthop. 2005;76:796-802. https://doi.org/10.1080/17453670510045390
  23. Marchetti P, Binazzi R, Vaccari V, et al. Long-term results with cementless Fitek (or Fitmore) cups. J Arthroplasty. 2005;20:730-7. https://doi.org/10.1016/j.arth.2004.11.019
  24. Li WC, Xu RJ. Lateral shelf acetabuloplasty for severe Legg-Calve-Perthes disease in patients older than 8 years: a mean eleven-year follow-up. Medicine (Baltimore). 2016;95:e5272. https://doi.org/10.1097/MD.0000000000005272
  25. Ireland DC, Fisher RL. Subtrochanteric fractures of the femur in children. Clin Orthop Relat Res. 1975;(110):157-66. https://doi.org/10.1097/00003086-197507000-00020
  26. Theologis TN, Cole WG. Management of subtrochanteric fractures of the femur in children. J Pediatr Orthop. 1998;18:22-5.
  27. Jarvis J, Davidson D, Letts M. Management of subtrochanteric fractures in skeletally immature adolescents. J Trauma. 2006;60:613-9. https://doi.org/10.1097/01.ta.0000197606.63124.9e
  28. Atassi O, Fontenot PB, Busel G, et al. "Unstable" pediatric femoral shaft fractures treated with flexible elastic nails have few complications. J Orthop Trauma. 2021;35:e56-60. https://doi.org/10.1097/BOT.0000000000001886
  29. Canavese F, Marengo L, Andreacchio A, et al. Complications of elastic stable intramedullary nailing of femoral shaft fractures in children weighing fifty kilograms (one hundred and ten pounds) and more. Int Orthop. 2016;40:2627-34. https://doi.org/10.1007/s00264-016-3259-3
  30. Andreacchio A, Alberghina F, Marengo L, Canavese F. Pediatric tibia and femur fractures in patients weighing more than 50 kg (110 lb): mini-review on current treatment options and outcome. Musculoskelet Surg. 2019;103:23-30. https://doi.org/10.1007/s12306-018-0570-8
  31. Saseendar S, Menon J, Patro DK. Complications and failures of titanium elastic nailing in pediatric femur fractures. Eur J Orthop Surg Traumatol. 2010;20:635-44. https://doi.org/10.1007/s00590-010-0637-1
  32. Mileski RA, Garvin KL, Huurman WW. Avascular necrosis of the femoral head after closed intramedullary shortening in an adolescent. J Pediatr Orthop. 1995;15:24-6. https://doi.org/10.1097/01241398-199501000-00006
  33. O'Malley DE, Mazur JM, Cummings RJ. Femoral head avascular necrosis associated with intramedullary nailing in an adolescent. J Pediatr Orthop. 1995;15:21-3. https://doi.org/10.1097/01241398-199501000-00005
  34. Gonzalez-Herranz P, Burgos-Flores J, Rapariz JM, Lopez-Mondejar JA, Ocete JG, Amaya S. Intramedullary nailing of the femur in children. Effects on its proximal end. J Bone Joint Surg Br. 1995;77:262-6.
  35. Raney EM, Ogden JA, Grogan DP.Premature greater trochanteric epiphysiodesis secondary to intramedullary femoral rodding. J Pediatr Orthop. 1993;13:516-20. https://doi.org/10.1097/01241398-199307000-00018
  36. Linke B, Ansari Moein C, Bosl O, et al. Lateral insertion points in antegrade femoral nailing and their influence on femoral bone strains. J Orthop Trauma. 2008;22:716-22. https://doi.org/10.1097/BOT.0b013e318189369e
  37. Tupis TM, Altman GT, Altman DT, Cook HA, Miller MC. Femoral bone strains during antegrade nailing: a comparison of two entry points with identical nails using finite element analysis. Clin Biomech (Bristol, Avon). 2012;27:354-9. https://doi.org/10.1016/j.clinbiomech.2011.11.002
  38. Herrera-Soto JA, Meuret R, Phillips JH, Vogel DJ. The management of pediatric subtrochanteric femur fractures with a statically locked intramedullary nail. J Orthop Trauma. 2015;29:e7-11. https://doi.org/10.1097/BOT.0000000000000156
  39. El-Sayed M, Abulsaad M, El-Hadidi M, El-Adl W, El-Batouty M. Reconstruction plate fixation of subtrochanteric femoral fractures in children. Acta Orthop Belg. 2007;73:484-90.
  40. Sanders S, Egol KA. Adult periarticular locking plates for the treatment of pediatric and adolescent subtrochanteric hip fractures. Bull NYU Hosp Jt Dis. 2009;67:370-3.
  41. Newbury AJ, Aurigemma P, Kraus M, Most M. The repair of an acute pathological subtrochanteric femur fracture using an adult 3.5-mm proximal humerus locking plate in an adolescent patient: a case report. JBJS Case Connect. 2020;10:e0491. https://doi.org/10.2106/JBJS.CC.19.00491
  42. Jain M, Doki S, Pradhan S, Panda S. Osteoid osteoma of calcar of femur in child: prophylactic fixation using PHILOS and excision. BMJ Case Rep. 2020;13:e235073. https://doi.org/10.1136/bcr-2020-235073